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Consideration of Prognostic Factors in Hypoglycemic Encephalopathy

机译：降血糖性脑病预后因素的考虑

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BACKGROUND: Recently, there are many reports about the association of Diffusion Weighted Imaging (DWI) and the prognosis of hypoglycemic encephalopathy (HE), but those relationships have not yet been completely determined. As such, we researched for prognosis, according to a variety of clinical data, and the lesion's distribution on DWI. METHODS: We retrospectively reviewed 19 patients who were diagnosed as HE. In addition, those prognoses were analyzed by a variety of clinical data and characteristics of lesion's distribution, which were evaluated on DWI and Apparent Diffusion Coefficient (ADC) maps. Three months later, those prognoses were determined by each Modified Rankin Scale. Further, the time-dependent average Glasgow Coma Scale (GCS), among the groups according to the characteristics of lesion's distributions in the initial DWI, was estimated. RESULTS: In this study, the difference of prognosis was not shown, according to all the clinical data, such as the severity or duration of the hypoglycemic state, but the group that did not have any pathologic lesion on the initial DWI demonstrated a better prognosis, in comparison with the groups-that exhibited any positive lesion on the initial DWI (p = 0.006). The group that had a focal pathologic lesion on the initial DWI showed a better prognosis than the diffuse lesion's group (p = 0.045). The groups with no lesion or focal lesion showed a faster recovery of GCS than the other groups with a positive lesion or diffuse lesion within the initial 1 week. CONCLUSIONS: We can identify that the characteristics of the lesion's distribution of DWI can be more helpful to predict of prognosis in HE than a variety of clinical data, such as the severity or duration of the hypoglycemic state.
机译：背景：近年来，有关弥散加权成像（DWI）与低血糖性脑病（HE）预后的关联的报道很多，但这些关系尚未完全确定。因此，我们根据各种临床数据和病变在DWI上的分布研究了预后。方法：我们回顾性检查了19例被诊断为HE的患者。此外，还通过各种临床数据和病变分布特征分析了这些预后，并在DWI和表观扩散系数（ADC）图上进行了评估。三个月后，这些预后由每个改良的Rankin量表确定。此外，根据初始DWI中病变分布的特征，估计各组中随时间变化的平均格拉斯哥昏迷量表（GCS）。结果：根据所有临床数据，例如低血糖状态的严重程度或持续时间，在该研究中未显示出预后的差异，但在初始DWI上未发现任何病理性病变的组预后较好与初始DWI上显示任何阳性病变的组相比（p = 0.006）。在最初的DWI中具有局灶性病变的组的预后要好于弥散性病变组（p = 0.045）。在开始的1周内，无病变或局灶性病变的组显示GCS的恢复快于具有阳性病变或弥散性病变的其他组。结论：我们可以确定，病变的DWI分布特征比低血糖状态的严重性或持续时间等各种临床数据更有助于预测HE的预后。

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